Vaginal Discharge Syndrome (VDS)

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VDS refers to change of colour, odour and/or amount of vaginal secretions.  

Causes 

  • T. vaginalis  
  • C. albicans 
  • Bacterial Vaginosis  
  • Neisseria gonorrhoeae 
  • Chlamydia trachomatis 

Clinical Presentation

  • Abnormal vaginal discharge  
  • Burning or painful micturition   
  • Itchy vulva
  • Increased  frequency  and  urgency of micturition and/or painful coitus  

Note:  

  • A spontaneous complaint of abnormal vaginal discharge is most commonly due to a vaginal infection
  • T.  vaginalis,  C.  albicans  and  Bacterial  Vaginosis  are  the  commonest  causes  of  vaginal infection  
  • Neisseria gonorrhoeae and Chlamydia trachomatis cause cervical infection.  
  • The clinical detection of cervical infection is difficult because a large proportion of women with gonococcal or chlamydia infections are asymptomatic
  • Vaginal  discharge  is  therefore  highly  indicative  of  vaginal  infection,  but  poorly  predictive  for cervical infection 
  • Due  to  the  high  prevalence  of  gonorrhea  and  chlamydia,  all  women  presenting  with  VDS should receive treatment for both vaginal and cervical infections
  • Delayed or inadequate treatment of VDS may result to endometritis, salpingitis, oophoritis or ectopic pregnancy.  
  • Gonococcal or chlamydial cervical infection may be asymptomatic 

Investigation(s) if the HF has a Laboratory capable of doing:  

  • Wet preparation 
  • Gram stain 
  • Culture and Sensitivity 
  • Fluorescent Microscopy 
  • Pap test (Papanicolau test)
  • ELISA
  • Quantitative or qualitative PCR
  • NB starts simple to complex

Management and Treatment of VDS (see flow chart 12.2)